Seminar #4: SC & IM Injections, SC Butterfly Flashcards
1
Q
Syringes parts
A
tip, barrel, plunger
2
Q
what is Luer Lock?
A
= syringe is threaded
2
Q
What is “not a luer lock”?
A
“slip tip” - end doesn’t screw onto syringe
3
Q
What’s the range for syringes?
A
0.5mL to 60mL
4
Q
What size syringe is used for SC or IM?
A
1mL to 3mL syringe
5
Q
when should a larger syringe be used?
A
if the syringe is more than 2/3 or 75% full
6
Q
What syringes have a non-removable needle?
A
smaller syringes, e.g., insulin + TB syringes
7
Q
What are syringes measured in?
A
can measure medications in units, decimals (tenths), or fractions; most are measured in mL
8
Q
What are needles made of and what do they consist of?
A
made of stainless steel
- consists of: hub, shaft, bevel
9
Q
How are needle lengths measured?
A
measured in inches and/ or mm
- varies from 1/2” to 1 1/2”
10
Q
what do you need to consider when choosing length of needle?
A
consider the route of the injection + client (age, weight, etc)
11
Q
What is the gauge?
A
the measurement of the size of the hole
12
Q
What is the gauge range?
A
16 to #28G
- the larger the gauge #, the smaller the diameter of the shaft
13
Q
what determines gauge size?
A
- viscosity of the medication
- location of injection
- type of injection (SC or IM)
14
Q
14 gauge color
A
green
15
Q
15 gauge colour
A
orange
16
Q
16 gauge colour
A
grey
17
Q
18 gauge colour
A
green
18
Q
20 gauge colour
A
pink
19
Q
21 gauge colour
A
purple
20
Q
Intradermal injection needle lengths
A
3/8 - 3/4 inch
21
Q
IM injection needle lengths
A
7/8” - 1 1/2”
22
Q
SC injection needle length
A
1/2” - 5/8”
23
Q
What are blunt fill needles for?
A
- for withdrawing medication
- to prevent glass particles from being drawn into syringe and put into pt
24
What is the lilac hub blunt needle?
Has filter, won't bring glass up into syringe
24
Red blunt fill needle?
No filter, for drawing up from vial, can be blunt from being poked through the top
25
What are ampoules?
single dose glass containers
- has distinctive shape with constricted neck
- some have coloured markings around neck scored for easy opening/ dot for pressure point
26
what's the range for ampoules?
1mL to 10mL
27
What do you label syringes containing medication for injections?
- 2 client identifiers
- name of medication
- dose/ volume
- route
28
SC injections -- syringe & needle size
- usually < 1mL injected via SC route
- syringe size: usually 1-3mL
- needle size: usually 25G, 5/8" long
29
Administer @ what degree?
45 degree angle if 2.5cm tissue can be grasped
90 degree angle if 5cm tissue can be grasped at site
30
Why do SC injections need to be rotated?
- minimize tissue damage
- maintain absorption
- avoid discomfort
31
where is SC heparin always injected?
given in abdomen, slower absorption rate bc of subcu fat
- can use alternate sites
32
SC Injection sites - how to choose
anywhere there is enough SC tissue to "pinch an inch"
- important to rotate sites and not use same area for days
- medication/solution injected into loose connective tissue just under dermis
33
SC Heparin injections
- should be injected at least 5cm away from umbilicus
- injected @ 90 degrees
- assess abdomen for trauma prior to selecting injection sites
- no bruises, lesions, stretch marks, is intact
- usually 2x/day, will see little bruised spot so pick another one
34
Insulin admin via syringe units
- 30 units, 50 units, or 100 units
- needles come attached to insulin syringes
- can be supplied in multidose vials - check expiration date
35
insulin needle length + gauge
26-31 gauge, 1/4 - 1/2" long
36
Drawing insulin steps
1. roll to mix syringe
2. insert air into cloudy
3. insert air into clear
4. draw from clear
5. draw from cloudy
37
where can insulin via syringe be injected?
absorbed more quickly in:
1. abdomen, then
2. arms, then
3. thighs & buttocks
38
Priming SCBF
line + needleless cap must be primed after insertion
- small amount of air will be injected into pt
39
40
Initial priming volume:
add device line mL + needleless cap mL altogether = 0.36, in addition to dose of medication total
41
SCBF insertion angle
grab wings to insert into pt, pinch skin 30-45 degree angle
42
# days + how many meds/one
What to know about SC injection?
- SCBF devices only used for specific medication + concentration on label
- if concentration/drug changes -- need to insert new one
- used up to 7 days
43
Intramuscular injections
- quicker absorption from muscle tissue (slower than IV)
- faster onset of action
- muscles can accept larger volume of medications, can accept some irritating ones
44
What syringe + needles for IM?
- 1-3mL syringe
- 21-32G
- 1/2 to 1 1/2 long needle
- obese pts may req longer needle, up to 3" long
45
How to give IM injection
don't pinch, support wherever you give it
- don't bend needle, quick and fast, 90 degrees
- inject slowly, 5-10s
46
Considerations for IM injection
length - site + weight of pt
gauge - viscosity of liquid
site - medication + volume
volume - determined by muscle development + mass
47
preferred site for IM injections?
ventrogluteal
- preferred site in adults
- typically up to 3mL (some 5mL)
48
IM Ventrogluteal site - pt position
side-lying = best
supine
prone
- don't want muscle to be flexed, will hurt more + harder to get into muscle
- don't hold arm up -- have them rest it on something
49
landmark identifiers for ventrogluteal injection
greater trochanter
iliac crest
anterior superior iliac spine
50
IM - Deltoid site
- lateral aspect of arm, up to 2mL
identifiers:
- acromion process - inject in muscle approx 3-5cm below acromion process (2-3 fingers down)
- axilla (deltoid narrows)
- assess muscle b4 injection
51
# what is it? how many mL?
Vastus Lateralis - IM site
- thick/well developed muscle
- typically up to 3mL (some 5mL)
- used more in babies bc muscle is more developed
52
Position + landmark identifiers for Vastus Lateralis
position: supine, sitting
landmarkers:
- anterior lateral aspect of thigh into middle 3rd
- greater trochanter
- lateral femoral condyle
53
# where? how many mL?
IM: Rectus Femoris
anterior aspect of thigh
typically up to 3mL (max 5mL)
easy to self-administer medication
can cause discomfort
54
Rectus Femoris - position + landmarkers
positioning: sitting, lying
landmark identifiers:
- anterior aspect of thigh
- anterior superior iliac crest
- patella
55
IM: Dorsogluteal - why is it not recommended?
- risk for sciatic nerve damage
- often end up in SC tissue, not muscle
- dorso gluteal given in upper outer quadrant of buttock muscle
56
IM injection risks
- pain
- bleeding
- abscess
- cellulitis
- tissue necrosis
- granuloma
- muscle fibrosis
- contractures
- hematoma
- injury to bld vessels, bone, nerves
57
IM/ SC injections: aspirate or no?
IM: don't aspirate - recommendations can vary
SC: not recommended
58
IM: what method for more irritating medications?
Z-track method - pull skin aside, inject, pull it out, then release skin
- seal formed over IM site after skin returns to normal position
- prevents seepage of med into SC tissue
